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Epr and pressure settings
#41
RE: Epr and pressure settings
Since the Resmed AS10 is limited in reducing Flow Limits, at what point should one consider Bi-level machine?
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#42
RE: Epr and pressure settings
It's a good question. Could you post a recent chart and also tell us how you are feeling?
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#43
RE: Epr and pressure settings
    OK. Here's a screenshot. Most day I feel ok. Although I sometimes need to take sa nap in the afternoon.
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#44
RE: Epr and pressure settings
If a bilevel (Vauto) comes available to you at a price you can afford, don't turn it down. I kind of draw an informal line at a 95% flow limit above 0.1 or where the flow limitations routinely drive pressure to the maximum set pressure. Both of those criteria are met in that chart. I assume that your inspiration flow is flattened or downward sloping most of the night?
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#45
RE: Epr and pressure settings
How do I see inspiration flow? I don’t see a chart with that name.
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#46
RE: Epr and pressure settings
It is in the flow rate chart.  You need to zoom in to a 2-minute segment to show the actual shape of the curve. If you repeatedly click on the graph it will zoom in.  The link in my signature for Organizing your OSCAR Chart has instruction. The section on Zooming and customizing images is here http://www.apneaboard.com/wiki/index.php...al_options   You can make the Flow Chart even tighter by changing the Y-Axis scale.  In your case a minimum and maximum scale of -100 to +100 would be very good.

[Image: Dashed-line.png]
Sleeprider
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____________________________________________
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Attaching Files
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#47
RE: Epr and pressure settings
    Here is a screenshot you talked about.
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#48
RE: Epr and pressure settings
Hi Deweym, you might try changing the scale on your flow rate graph to something like +/- 50 or 60.  That will make it easier to see details.  

I'm attaching a zoomed in view of some typical flow limitations I had before I switched to a bi-level machine.  (Ignore the squiggles between breaths.  Those are a phenomenon called cardioballistic artifact, which just means my heartbeat causes little pulsations in my flow rate.)

Flow-limited breaths will usually show a dent in the top of what should be a smooth inhalation curve, or a pointy peak, or a plateau.


Attached Files Thumbnail(s)
   
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#49
RE: Epr and pressure settings
    OK. Here is a revised screenshot.
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#50
RE: Epr and pressure settings
Deweym, your flow rate shows a low amplitude inspiration with a somewhat flat peak, but not very flow limited.  At this time in your full-night chart, you were not experiencing much flow limitation and it was one of the few periods with pressure well below your maximum.  This is not typical of your usual results  I think if this was typical, you'd be fine, but it is the exception.  

It's possible that more pressure suport from bilevel would help you to get a full breath, and likely a bit faster.  I'm sure I mentioned your unusually low tidal volume in the past.  I don't know your height, age or other factors, but that is very shallow breathing.  Whether it is sufficient for you could be established by using a recording oximeter to measure SpO2.  Bilevel would likely increase your respiratory volume if the low flow rates are due to a restricted airway (upper airway resistance).  The fact your flow limitations are chronic and persistent, makes me think a higher pressure support would be beneficial.

[Image: attachment.php?aid=21310]
Sleeprider
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www.ApneaBoard.com

____________________________________________
Download OSCAR Software
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Attaching Files
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How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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